D and C stands for "dilation and curettage". Dilation (or dilatation) and curettage is one of the most common surgical procedures. It is also one of the safest.
The American College of Obstetricians and Gynecologists (ACOG) website stated that ʺa D&C is a procedure in which the cervix is dilated to make it wider and a sample of tissue is removed from the lining of the uterus.ʺ
ʺCurettage may be performed by scraping the uterine wall with a curette instrument or by a suction curettage (also called vacuum aspiration), using a vacuum-type instrument,ʺ revealed the American Pregnancy Association website.
According to the National Library of Medicine, a D and C procedure may be performed for one of the following medical reasons:
• Heavy menstrual bleeding
• Abnormal bleeding (during after menopause)
• Benign tumors
• Malignant cancer
• Adenomyosis
• Pelvic Inflammatory Disease (PID)
• Miscarriage or elective abortion
• IUD Removal
• Women unable to get pregnant
The American Pregnancy Association said, ʺabout 50 percent of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks. After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure to be performed. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice, best decided after talking with your health care provider.ʺ
The procedure is generally conducted in a surgical setting. A D&C can occur as an inpatient or outpatient procedure. You may receive one of the following types anesthesia: general, IV or paracervical before the procedure.
According to the APA the following is how a D&C is conducted:
• The cervix is examined to evaluate if it is open or not.
• If the cervix is closed, dilators (narrow instruments in varying sizes) will be inserted to open the cervix to allow the surgical instruments to pass through.
• A speculum will be placed to keep the cervix open.
• The vacuum aspiration (also called suction curettage) procedure uses a plastic cannula (a flexible tube) attached to a suction device to remove the contents of the uterus.
• The cannula is approximately the diameter in millimeters as the number of weeks gestation the pregnancy is. For example, a 7mm cannula would be used for a pregnancy that is 7 weeks gestation. The use of a curette (sharp-edged loop) to scrape the lining of the uterus may also be used, but is often not necessary.
• The tissue removed during the procedure may be sent off to the pathology lab for testing.
• Once the health care provider has seen that the uterus has firmed up and that the bleeding has stopped or is minimal, the speculum will be removed and you will be sent to recovery.
After the procedure and to prevent infection, your doctor may prescribe antibiotics. Also, you can return to normal non-strenuous activity after 24 hours. You may suffer from light cramping.
It is also very important not to use tampons after a D and C. You should have a normal period two to six weeks after the procedure.
Also, it is important to monitor your body after the D and C. If you experience any of the following complications, contact your health care provider immediately:
• Foul smelling discharge
• Dizziness or fainting
• Fever over 100.4 °F or chills
• Prolonged bleeding (over 2 weeks)
• Bleeding more than a menstrual period, or filling more than a pad an hour
• Prolonged cramping (over 2 weeks)
• Severe or increased pain
References:
D and C: MedlinePlus Medical Encyclopedia. National Library of Medicine - National Institutes of Health. Retrieved March 17, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/002914.htm
D&C. American College of Obstetricians and Gynecologists (. Retrieved March 17, 2012, from www.acog.org/~/media/For%20Patients/faq062.pdf?dmc=1&ts=20120317T2130458951
D&C procedure after a Miscarriage: American Pregnancy Association. Promoting Pregnancy Wellness: American Pregnancy Association. Retrieved March 17, 2012, from
http://www.americanpregnancy.org/pregnancycomplications/dandc.html
Dilation and Curettage: MedlinePlus Interactive Health Tutorial from the Patient Education Institute. National Library of Medicine - National Institutes of Health. Retrieved March 17, 2012, from http://www.nlm.nih.gov/medlineplus/tutorials/dilatationandcurettage/htm/index.htm
Reviewed March 20, 2012
by Michele Blacksberg RN
Edited by Jody Smith